Nasal corticosteroid medications

Persons who are using drugs that suppress the immune system (., corticosteroids) are more
susceptible to infections than healthy individuals. Chickenpox and measles , for example, can have a
more serious or even fatal course in susceptible children or adults using corticosteroids. In children or
adults who have not had these diseases or been properly immunized, particular care should be taken to
avoid exposure. How the dose, route, and duration of corticosteroid administration affect the risk of
developing a disseminated infection is not known. The contribution of the underlying disease and/or
prior corticosteroid treatment to the risk is also not known. If a patient is exposed to chickenpox,
prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If a patient is exposed to
measles, prophylaxis with pooled intramuscular immunoglobulin ( IG ) may be indicated (see the
respective package inserts for complete VZIG and IG prescribing information). If chickenpox or
measles develops, treatment with antiviral agents may be considered.

Mometasone furoate increased chromosomal aberrations in an in vitro Chinese hamster ovary-cell assay,
but did not increase chromosomal aberrations in an in vitro Chinese hamster lung cell assay.
Mometasone furoate was not mutagenic in the Ames test or mouse- lymphoma assay, and was not
clastogenic in an in vivo mouse micronucleus assay and a rat bone marrow chromosomal aberration
assay or a mouse male germ -cell chromosomal aberration assay. Mometasone furoate also did not
induce unscheduled DNA synthesis in vivo in rat hepatocytes.

The acute toxicity of budesonide is low and of the same order of magnitude and type as that of the reference glucocorticoids studied (beclomethasone dipropionate, flucinolone acetonide). Results from subacute and chronic toxicity studies show that the systemic effects of budesonide are less severe than or similar to those observed after administration of the other glucocorticosteroids . decreased body weight gain and atrophy of lymphoid tissues and adrenal cortex. An increased incidence of brain gliomas in male rats in a carcinogenicity study could not be verified in a repeat study, in which the incidence of gliomas did not differ between any of the groups on active treatment (budesonide, prednisolone, triamcinolone acetonide) and the control groups. Liver changes (primary hepatocellular neoplasms) found in male rats in the original carcinogenicity study were noted again in the repeat study with budesonide, as well as with the reference glucocorticosteroids. These effects are most probably related to a receptor effect and thus represent a class effect.

Ravindhra G Elluru, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery , American Academy of Pediatrics , American Bronchoesophagological Association , American College of Surgeons , American Medical Association , Association for Research in Otolaryngology , Society for Ear, Nose and Throat Advances in Children , Triological Society , American Society for Cell Biology

Disclosure: Nothing to disclose.

Nasal corticosteroid medications

Ravindhra G Elluru, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery , American Academy of Pediatrics , American Bronchoesophagological Association , American College of Surgeons , American Medical Association , Association for Research in Otolaryngology , Society for Ear, Nose and Throat Advances in Children , Triological Society , American Society for Cell Biology